Injuries to face, ears, eyes, nose, throat

Question 1

Prorities in facial trauma (5)

Answer 1

• Airway maintence
• in line imobalizatioon (if suspecting spinal)
• oro-phaeynx bleeding control
• LOC management
• Shock prevention/tx

Question 2

evaluation for facial injuries steps

Answer 2

Observe- Look for ecchymosis, swelling, lacerations, puncture wounds etc
-Check for CSF from ears/nose, racoon eyes, battle sign, blood from ear

Question 3

First aid for facial injuries (general)

Answer 3

Check scene
Call EMS (if life threatening injury)
Care: ABCs
Secondary: tx non life threatening, control bleeding, pt forward lean so blood goes out

Question 4

When should u suspect a facial fx

Answer 4

• facia features distorted
• pt ecperiencing any numbness/pain
• hard to open/close jaw
• Teeth no longer normally aligned
• double vision

Question 5

Signs + symptoms of facial fx

Answer 5

• malocclusion
• elongated face
• epistaxis
• periorbital deformity
• facial ecchymosis

Question 6

most import item to note on initial facial exam

Answer 6

Dental occlusion

–When teeth don’t line up and the jaw isn’t closing right

Question 7

What % of dental injuries are sport related

Answer 7

13-39%
(most aged 8-5)
mc upper incisors

Question 8

management for soft tissue dental injury

Answer 8

• small cuts/hematomas best tx with direct pressure and ice
• large internal cuts in mouth bleed profusely but heal quick
• larger extra oral cuts must be cleaned and closed with stern strips

Question 9

Crown/root fx management

Answer 9

If pulp (nerve) is involved, need to cover fractured part ASAP
-Need urgent dental tx to prevent infection and prevent the need for root canal

Question 10

Tooth displacement tx

Answer 10

• Put affected teeth back into as normal a pos as possible
• hold them in place
• immediate dental consult

Question 11

Tooth avulsion (tooth popped out) tx

Answer 11

Replace tooth in socket ASAP
rinse debris off tooth
handle tooth by crown
if can’t be reimplanted store tooth in appropriate medium

Question 12

Storage mediums for teeth

Answer 12

dry <30m
Tap water 30-60mins
vestibule of mouth 90-120
physiologic saline 90-120
cold milk 3hr

Question 13

internal bleeding control of cheek management

Answer 13

place several folded dressings inside mouth against cheek, apply pressure

Question 14

External bleeding control

Answer 14

-place several dressings on the outside of the cheek and apply pressure

Question 15

Emmbed objects in cheek managemetn

Answer 15

may have to be removed to control bleeding and protect airway
-ONLY exertion to general rule of not removing embedded objects

Question 16

eye exam serious symptims

Answer 16

Tensly swolen, ecchymosis, eyelids don’t open together

Question 17

Eye injury exam

Answer 17

Inspect: conjunctiva, sclera, pupils, iri, cornea
palpate orbital rim
examine for exophthalmos, enophthalmos
Movement (H patten)
Visual acuity (sneellin)

Question 18

what does PERRLA stand for in eye exam

Answer 18

Pupils equal
round
reactive to Light
Accomidation`

Question 19

Extruded eye tx

Answer 19

• do not try to put back in
• tx associated injuries and control bleeding
• apply sterile saline wetted dressing around eye
• apply a cut or ring tent manage over eye
• patch opposite eye (due to congugated mints)

Question 20

tx of burn to eye

Answer 20

flush w sterile saline/water

-Flush the eye from the inner corner to outer (prevent from getting in other eye)

Question 21

urgent eye referral via 911

Answer 21

Ruptured globe, extruded eye, embedded sharp object

Question 22

When to refer to opthalmologist asap rocky

Answer 22

Visual field loss
visual acuity loss
photophobia
diplopia

Question 23

tx of auricular hematomas

Answer 23

• ice local
• sterile needle aspiration
• after aspiration, contoured compression dressing is applied
• repeated aspiration as needed

Question 24

Tympanic membrane rupture s/s

Answer 24

• Pain and varying severity
• muffled hearing
• possibly bleeding
• tinitus
• vertigo

Question 25

Epistaxis (nosebleed) tx

Answer 25

• leaning forward pos
• tell to compress entire fleshy part below bridge and maintain compression until bleeding stops
• if doesn’t stop in 20 transport to hospital

Question 26

if blood from nose is kinda yellow

Answer 26

CSF, suspect skull fx

Question 27

tx for nose fx

Answer 27

control bleeding

• pt pos seated and leaning forward
• if reduction is required, ideally it is carried out immediately

Question 28

Classic symptoms of laryngeal trauma

Answer 28

• hoarsness
• dyspnea
• dysphagia
• pai/tendernesss of ant neck

Question 29

tx for throat lacerations

Answer 29

• Apply direct pressure to the affected side
• apply a sterile first layer then continue to add bandages
• control bleeding and then protect + maintain airways
• once bleeding controlled apply supplemental oxygen